Foam introduction system including modified port geometry

ABSTRACT

A surgical apparatus for positioning within a tissue tract accessing an underlying body cavity includes a seal anchor member including leading portion, a trailing portion, and an intermediate portion disposed between the leading and trailing portions. The leading portion of the seal anchor member is configured and adapted to ease insertion of the seal anchor member into the tissue tract. Subsequent to insertion of the seal anchor member, the leading portion of the seal anchor member is also configured and adapted to facilitate securing and/or anchoring of the seal anchor member within the tissue tract.

CROSS REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.14/310,068 filed Jun. 20, 2014, which is a continuation of U.S. patentapplication Ser. No. 13/913,552 filed Jun. 10, 2013, now U.S. Pat. No.8,795,289, which is a divisional of U.S. patent application Ser. No.12/939,204 filed Nov. 4, 2010, now U.S. Pat. No. 8,480,683, which claimsbenefit of U.S. Provisional Application No. 61/263,927 filed Nov. 24,2009, and the disclosures of each of the above-identified applicationsare hereby incorporated by reference in their entirety.

BACKGROUND

Technical Field

The present disclosure relates generally to a seal for use in a surgicalprocedure. More particularly, the present disclosure relates to a sealanchor member adapted for insertion into an incision, or a naturallyoccurring bodily orifice, in tissue, and, for the sealed reception ofone or more surgical objects such that a substantially fluid-tight sealis formed with both the tissue and the surgical object or objects.

Background of Related Art

A minimally invasive surgical procedure is one in which a surgeon entersa patient's body through a small opening in the skin or through anaturally occurring opening (e.g., mouth, anus, or vagina). Suchprocedures have several advantages over traditional open surgeries. Inparticular, as compared to traditional open surgeries, minimallyinvasive surgical procedures result in reduced trauma and recovery timefor patients. Generally, such procedures are referred to as“endoscopic”, unless performed on the patient's abdomen, in which casethe procedure is referred to as “laparoscopic”. Throughout the presentdisclosure, the term “minimally invasive” should be understood toencompass both endoscopic and laparoscopic procedures.

During a typical minimally invasive procedure, surgical objects, such assurgical access devices (e.g., trocar and cannula assemblies) orendoscopes, are inserted into the patient's body through the incision intissue. In general, prior to the introduction of the surgical objectinto the patient's body, insufflation gases are used to enlarge the areasurrounding the target surgical site to create a larger, more accessiblework area. Accordingly, the maintenance of a substantially fluid-tightseal is desirable so as to prevent the escape of the insufflation gasesand the deflation or collapse of the enlarged surgical site.

To this end, various valves and seals are used during the course ofminimally invasive procedures and are widely known in the art. However,a continuing need exists for a seal anchor member that can be inserteddirectly into the incision in tissue and that can accommodate a varietyof surgical objects while maintaining the integrity of an insufflatedworkspace.

SUMMARY

Disclosed herein is a surgical apparatus for positioning within a tissuetract accessing an underlying body cavity. The surgical apparatusincludes a seal anchor member including a leading portion, a trailingportion, and an intermediate portion disposed between the leading andtrailing portions. One or more lumens longitudinally extend between theleading and trailing portions. The one or more lumens are configured andadapted to receive instrumentation therein in a substantially sealedrelation.

The leading portion of the seal anchor member is transitionable betweena first configuration and a second configuration. The leading portionmay define a radial dimension, diameter or a width that corresponds toeach of the first and second configurations. In an embodiment, theleading portion includes a plurality of positioning members defining atleast one gap between adjacent positioning members to facilitatecompression of the leading portion in a transverse direction. The atleast one gap facilitates transitioning the leading portion to thesecond configuration in which the leading portion has a substantiallyflat profile, thereby facilitating insertion of the seal anchor memberwithin the tissue tract.

In another embodiment, the leading portion of the seal anchor member mayinclude one or more positioning segments that are radially coupled tothe intermediate portion of the seal anchor member, e.g., the one ormore positioning members are operably connected to the intermediateportion. To facilitate insertion of the seal anchor member within thetissue member the one or more positioning members are inwardly directedto minimize the size of the leading portion of the seal anchor member.Once inserted into the tissue tract, the one or more positioning membersmay outwardly deploy, thereby increasing the size of the leading portionof the seal anchor member and facilitating stabilization and/oranchoring of the seal anchor member within the tissue tract. The one ormore positioning members may be inwardly biased, and may outwardlydeflect in response to insertion of instrumentation through the lumensof the seal anchor member.

In yet another embodiment, a seal anchor member may include a leadingportion, a trailing portion, and an intermediate portion disposedtherebetween. A first positioning member may be associated with thetrailing portion, and a second positioning member may be associated withthe leading portion. The second positioning member may have anon-circular, e.g., an oblong, shape or configuration. The non-circularshape of the second positioning member facilitates insertion by guidingthe seal anchor member to a proper position within the tissue tract.Once positioned within the tissue tract, the non-circular shape of thesecond positioning member also facilitates anchoring and/or securing ofthe seal anchor member within the tissue tract. The seal anchor membermay also include one or more longitudinally extending lumens between theleading and trailing portions of the seal anchor member.

These and other features of the apparatus disclosed herein will becomemore readily apparent to those skilled in the art from the followingdetailed description of various embodiments of the present disclosure.

BRIEF DESCRIPTION OF THE DRAWINGS

Various embodiments of the present disclosure are described hereinbelowwith reference to the drawings, wherein:

FIG. 1 is a perspective view of a seal anchor member in accordance withthe principles of the present disclosure shown in a first conditionpositioned relative to tissue;

FIG. 2 is a bottom view of the seal anchor member of FIG. 1;

FIG. 3 is a bottom view of the seal anchor member of FIG. 1 shown in asecond condition;

FIG. 3A is a bottom view of a seal anchor member having a single annularpositioning member;

FIG. 4 is a perspective view of another embodiment of a seal anchormember in accordance with the principles of the present disclosure shownin a first condition;

FIG. 5 is a perspective view of the seal anchor member of FIG. 4 shownpartially inserted within tissue;

FIG. 6A is a perspective view of yet another embodiment of a seal anchormember in accordance with the principles of the present disclosure shownin a first condition;

FIG. 6B is a perspective view of the seal anchor member of FIG. 6A shownin a second condition;

FIG. 7A is perspective view of the seal anchor member of FIG. 6A, shownplaced within a wound within a tissue, while in the first condition; and

FIG. 7B is a perspective view of the seal anchor member of FIG. 6A,shown placed within a wound within a tissue, while in the secondcondition.

FIG. 8 is a top perspective view of yet another embodiment of a sealanchor member in accordance with the present disclosure;

FIG. 9 is a bottom perspective view of the seal anchor member of FIG. 8;

FIG. 10 is a top view of the seal anchor member of FIG. 8;

FIG. 11 is a side view of the seal anchor member of FIG. 8;

FIG. 12 is a top, partially cut-away view of the seal anchor member ofFIG. 8;

FIG. 13 is a side cross-sectional view of the seal anchor member of FIG.8 taken along section-line 13 as shown in FIG. 12;

FIG. 14 is a perspective view of the seal anchor member of FIG. 8 shownplaced within an incision in a first condition;

FIG. 15 is a side cross-sectional view, taken along section-line 15-15,of the seal anchor member of FIG. 8 as shown in FIG. 14; and

FIG. 16 is a side cross-sectional view of the seal anchor member of FIG.8 as shown in FIG. 15 in a second condition.

DETAILED DESCRIPTION OF EMBODIMENTS

In the figures and in the description that follows, in which likereference numerals identify similar or identical elements, the term“proximal” will refer to the end of the apparatus that is closest to theclinician during use, while the term “distal” will refer to the end thatis farthest from the clinician, as is traditional and known in the art.

With reference to FIGS. 1-3, a seal anchor member 100 will now bedescribed. Seal anchor member 100 includes a body 112 defining alongitudinal axis “A” and having respective trailing (proximal) andleading (distal) ends 102, 104, and an intermediate section 106 disposedbetween the trailing and leading portions 102, 104. Seal anchor member100 includes one or more ports 108 a, 108 b, 108 c that extend generallylongitudinally between trailing and leading portions 102, 104,respectively, and through seal anchor member 100.

Associated with trailing and leading portions 102, 104 are positioningmembers 116 and 114 a-d, respectively. Positioning members 116, 114 a-dmay be composed of any suitable material that is at least semi-resilientto facilitate resilient deformation of the positioning members 116, 114a-d. The positioning members 116, 114 a-d may exhibit any suitableconfiguration and may be, for example, substantially annular-shaped oroval-shaped arrangement. As shown in FIG. 2, a diameter of the leadingportion 104, when in its initial, expanded, condition, has dimension“De”.

As shown best in FIG. 2, associated with the leading portion 104 arepositioning members 114 a, 114 b, 114 c, 114 d that are separated bysurfaces 115 a, 115 b, 115 c, 115 d that define gaps among positioningmembers 114 a, 114 b, 114 c, 114 d. While four positioning members 114a-d are depicted in FIGS. 1-3, a greater or lesser number of positioningmembers, configured to define gaps therebetween, may be utilized toachieve a desired configuration of the seal anchor member 100 whencompressed.

For insertion of seal anchor member 100 within a tissue tract 12,positioning members 114 a-d are brought in closer proximity to oneanother to facilitate placement of the seal anchor member 100 within thetissue tract. The separation between the positioning members 114 a-dfacilitates transition of the distal end 104 between a substantiallyannular profile (FIG. 2) to a substantially rectangular profile (FIG.3). The gaps between the positioning members 114 a-dhelp facilitate thetransition of leading portion 104 to a substantially flatter profile,such that distal end 104 has a dimension “Dc”, as shown in FIG. 3, uponapplication of a force “F” than may have been achievable in the absenceof such gaps. In particular, if the distal end 104 included only asingle annular positioning member, compression of the distal end 104would result in a non-uniform contour (FIG. 3A) of the seal anchormember 100, e.g., the seal anchor member 100 would be compressed moregreatly, e.g., would be flatter, at the point of the application of theforce and less greatly farther away from that point.

Subsequent to insertion of the seal anchor member 100 within the tissuetract, the resilient nature of the positioning members 114 a-d, 116allows the positioning members to expand to approximate the tissue tract12 when seal anchor member 100 is inserted. Positioning members 114 a-d,116 may engage walls defining the body cavity to further facilitatesecurement of seal anchor member 100 within the body tissue “T”. Forexample, positioning members 114 a-d at leading portion 104 may engagethe internal peritoneal wall and positioning member 116 adjacenttrailing portion 102 may engage the outer epidermal tissue adjacent theincision 12 within tissue “T”.

The use and function of seal anchor member 100 during the course of atypical minimally invasive procedure will now be discussed. Initially,an incision is made through the tissue. Such an incision is typicallymade with a scalpel or the like, resulting in a generally slit-shapedopening. Next, a body cavity, e.g., the peritoneal cavity, isinsufflated with a suitable biocompatible gas such as, e.g., carbondioxide, such that the cavity wall is raised and lifted away from theinternal organs and tissue housed therein, providing greater accessthereto. Insufflation of the body cavity may be performed with aninsufflation needle or similar device, as is conventional in the art.

The seal anchor member 100 is in an expanded state at rest, as shown inFIG. 2. Insertion of the seal anchor member 100 within the tissue tract12 is achievable by compressing the leading portion 104 of the sealanchor member 100. Positioning member 114 is adapted and configured tobecome substantially flat (when viewed from below) upon the applicationof a force “F” as seen in FIG. 3. Compression of the seal anchor member100 facilitates insertion of the seal anchor member 100 into the tissuetract 12. Subsequent to the insertion of the seal anchor member 100,leading portion 104, positioning members 114 a-d and at least a section112 of intermediate portion 106 are disposed beneath tissue “T”. Sealanchor member 100 is caused to transition from the compressed state asshown in FIG. 3 towards the expanded state (FIG. 1) by removing force“F” therefrom. Expansion of the section 112 of the intermediate portion106 is limited by the tissue surfaces 14 (FIG. 1) defining tissue tract12, thereby subjecting intermediate portion 106 to an external force “F”that is directed inwardly. The internal biasing force of seal anchormember 100 is outwardly directed and is exerted upon tissue surfaces 14upon insertion of the seal anchor member 100 within tissue tract 12,thereby facilitating a substantially fluid-tight seal between the sealanchor member 100 and tissue surfaces 14 and substantially preventingthe escape of insufflation gas around seal anchor member 100 and throughtissue tract 12.

In the expanded condition, the respective radial dimensions D₁, D₂ ofthe trailing and leading portions 102, 104 are substantially larger thanthe radial dimension R of the intermediate portion 106 thereby givingseal anchor member 100 an “hour-glass” configuration. Subsequent toinsertion, the radial dimension D₂ of distal end 104 increases toprovide an interference fit with the tissue tract 12. Consequently, sealanchor member 100 resists removal from tissue tract 12 when in theexpanded condition and thus, seal anchor member 100 will remain anchoredwithin the tissue “T” until it is returned to its compressed conditionand is pulled out of the tissue tract 12.

Optionally, as shown in FIGS. 1-2, each of the positioning members 114a-d at the distal end 104 of the seal anchor member 100 may include alumen 118 a, 118 b, 118 c, 118 d, respectively. Lumens 118 a-d areconfigured and adapted to receive a drawstring 117 therein. Seal anchormember 100 may further include a longitudinally extending lumen 119adapted for reception of the drawstring 117. During a procedure, thesurgeon may move the drawstring 117 through lumen 119 by pulling thedrawstring 117 in a proximal direction thereby reducing the length ofthe drawstring 117 positioned within lumens 118 a-d. Moving thedrawstring 117 through lumen 119 forces the positioning members 114 a-dto move toward one another thereby reducing the gaps defined among thepositioning members 114 a-d.

During a surgical procedure, the surgeon places the seal anchor member100 relative to the tissue tract 12 of the tissue “T”, as shown inFIG. 1. As discussed above, the size of the distal end (leading end) 104is reduced by proximally pulling the drawstring 117. Once the distal end104 is sufficiently compressed (FIG. 3), the surgeon inserts the distalend 104 into the tissue tract 12. With the distal end 104 compressed,the seal anchor member 100 may taper from the proximal (trailing) to thedistal (lead) portions of the seal anchor member 100. Both the reducedcross-section of the distal end 104 and the resulting taper of the sealanchor member 100 facilitate the surgeon's insertion of the seal anchormember 100 into the tissue tract 12.

The internal bias of the seal anchor member 100 will apply a force totransition the distal end 104 back to its initial dimension “De”.Therefore, during insertion of the seal anchor member, the surgeon maycontinue to pull drawstring 117 proximally to maintain the compresseddimension “Dc” of the distal end 104. The material of the seal anchormember 100, e.g., a foam, may also facilitate a timed transition back tothe initial shape and dimension of the seal anchor member 100, therebyreducing the need to apply tension to the drawstring 117 duringinsertion. In an embodiment, a clip or another locking means may beemployed to secure the drawstring 117 in a given position, therebymaintaining a given dimension of the distal end 104 by inhibiting thetranslation of the drawstring 117 through the lumen 119.

Once the surgeon has placed the seal anchor member 100 within the tissuetract 12 as desired, the surgeon will permit the drawstring 117 totranslate. The internal biasing force of the seal anchor member 100 willbegin to transition the distal end 104 to the expanded dimension “De”.In the expanded state, the shape and configuration of the seal anchormember 100 facilitates anchoring of the seal anchor member 100 withinthe tissue tract 12. Once the seal anchor member 100 is anchored withinthe tissue tract 12, surgical instruments are inserted through lumens108 a-c.

Upon completion of the procedure, the instruments are removed, and thedrawstring 117 is once again translated proximally through lumen 119 toreduce the dimension of the distal end 104 toward the compresseddimension “Dc”. Thereafter, the surgeon removes the seal anchor member100 from the tissue tract 12. The reduced dimension of the distal end104 facilitates withdrawal of the seal anchor member 100 from within thetissue tract 12 of tissue “T”. The tissue tract 12 may then be closedthrough means known in the art, e.g., stapling or suturing.

In another embodiment of the present disclosure, a seal anchor member200 will now be described with reference to FIGS. 4 and 5. As shown bestin FIG. 4, the seal anchor member 200 defines a longitudinal axis “B”and having respective trailing (or proximal) and leading (or distal)ends 202, 204 and an intermediate portion 206 disposed between thetrailing and leading portions 202, 204. Seal anchor member 200 includesone or more ports 208 a, 208 b, 208 c that extend longitudinally betweentrailing and leading portions 202, 204, respectively, and through sealanchor member 200. Positioning members 213, 214 are respectivelyassociated with trailing portion 202 and leading portion 204.

Positioning member 214 has a non-circular, in this case, oblong shape.In an embodiment as shown in FIG. 4, the positioning member 214 has anoblong shape. The oblong shape of the positioning member 214 facilitatesinsertion of the seal anchor member 200 into the tissue tract 12. Distalend 214 a of positioning member 214 is configured to guide the sealanchor member 200 into the tissue tract 12.

Placement of the seal anchor member 200 within the tissue tract 12 willnow be described with reference to FIG. 5. As seen in FIG. 5,introduction of the seal anchor member 200 is achieved by placing distalend 214 a within the tissue tract and translating the seal anchor port200 along directional arrow “D” to place leading portion 204 withintissue tract 12. Surgical instruments may be used to grasp and positionthe leading portion 204 of the seal anchor member 200. Alternatively, asurgeon may select to grasp and position the leading portion 204 of theseal anchor member 200 with his or her hand. Upon placement of the sealanchor member 200 within the tissue tract 12, the surgeon may placeinstruments within the lumens 208 a-c.

Upon completion of the procedure, the seal anchor member 200 is removedfrom within the tissue tract 12. The seal anchor member 200 may beremoved by translating the seal anchor member along a path opposite thatdefined by directional arrow “D”. In addition, the seal anchor member200 may be formed from a compressible material. Where the seal anchormember 200 is formed from a compressible material, the surgeon mayreduce the dimensions of the seal anchor member 200 by squeezing theseal anchor member 200. The reduction in the dimensions of the sealanchor member 200 may also facilitate the removal of the seal anchormember 200 from within the tissue tract 12. The tissue tract 12 may thenbe closed through means known in the art, e.g., stapling or suturing.

With reference to FIGS. 6A-6B, a seal anchor member 300 will now bedescribed. The seal anchor member 300 includes a trailing (proximal) end302, a leading (distal) end 304, and an intermediate section 306disposed between the trailing and leading portions 302, 304. The sealanchor member 300 includes one or more longitudinally extending lumens308 a, 308 b. Each of the lumens 308 a-b is configured and adapted toreceive a surgical instrument “I” (FIG. 7B) therethrough in asubstantially sealed relationship.

The leading portion 304 includes one or more positioning segments 304 a,304 b. The positioning segments 304 a, 304 b are connected to theintermediate section 306 by a living hinge 310 a, 310 b, respectively.As shown in FIG. 6A, the seal anchor member 300 is in a first, collapsedposition in which positioning segments 304 a, 304 b are inwardlyretracted such that the leading portion 304 defines a first diameter D₃.In the second, expanded position, the positioning segments 304 a, 304 bhave been deployed in radial outward directions G, H, respectively.While in the second position, the leading portion 304 defines a seconddiameter D₄ that is greater than the first diameter D₃. Transitioning ofthe seal anchor member 300 between the first and second positionsnecessitates application of a force sufficient to radially translate thepositioning segments 304 a, 304 b.

As shown in FIG. 7A, when the seal anchor member 300 is in the first,collapsed position, placement of the seal anchor member 300 within wound“W” of the tissue “T” is facilitated by having a comparatively smallerdiameter. In addition, the comparatively smaller diameter may reduce theoverall size of the wound “W” necessary to place the seal anchor member300 within the wound “W”. As shown in FIG. 7B, insertion of surgicalinstruments “I” through the lumen 308 a, 308 b effects deployment of acorresponding positioning segment 304 a, 304 b. In particular, insertionof surgical instrument “I” through lumen 308 a effects a radialtranslation of positioning segment 304 a in the direction indicated byarrow G. Similarly, insertion of surgical instrument “I” through lumen308 b effects a radial translation of positioning segment 304 b in thedirection indicated by directional arrow H.

With the positioning segments 304 a, 304 b deployed, the seal anchormember 300 is anchored within the wound “W” of the tissue “T”. Inparticular, while the positioning segments 304 a, 304 b are in thedeployed condition, the interaction of the positioning segments 304 a,304 b with the tissue “T” inhibits the removal of the seal anchor member300 from the wound “W”.

With the positioning segments 304 a, 304 b retracted, the seal anchormember 300 is inserted into the wound “W”. Thereafter, the instruments“I” are inserted into lumens 308 a, 308 b. The insertion of theinstruments “I” into lumens 308 a, 308 b effects a correspondingdeployment of the positioning segments 304 a, 304 b in the directionindicated by arrows G, H, respectively. Upon completion of the surgicalprocedure, the seal anchor member 300 is removed from the wound “W” aswill now be described. Each of the instruments “I” is removed from thelumen 308 a, 308 b into which it was placed. The removal of theinstruments “I” effects retraction of the positioning segments 304 a,304 b since the positioning segments 304 a, 304 b are inwardly biased.The retraction of the positioning segments 304 a, 304 b facilitatesremoval of the seal anchor member 300 by reducing the dimension of theleading portion 304 of the seal anchor member 300. Thereafter, thesurgeon proximally translates the seal anchor member out of the wound“W”. The wound “W” may then be closed through means known in the art,e.g., stapling or suturing.

Although the illustrative embodiments of the present disclosure havebeen described herein with reference to the accompanying drawings, theabove description, disclosure, and figures should not be construed aslimiting, but merely as exemplifications of particular embodiments. Itis to be understood, therefore, that the disclosure is not limited tothose precise embodiments, and that various other changes andmodifications may be effected therein by one skilled in the art withoutdeparting from the scope or spirit of the disclosure.

1. (canceled)
 2. A surgical apparatus for positioning within a tissuetract accessing an underlying body cavity comprising: a seal anchormember including a leading portion, a trailing portion, and anintermediate portion disposed between the leading and trailing portions,the seal anchor member defining first and second ports extending betweenthe leading and trailing portions, each of the first and second portsconfigured to receive a surgical instrument in a sealing relation, theleading portion including first and second positioning memberstransitionable between a retracted position in which the first andsecond positioning members extend radially inward and a deployedposition in which the first and second positioning members extendradially outward to secure the seal anchor member within the tissuetract, the first and second positioning members biased toward theretracted position.
 3. The surgical apparatus according to claim 2,wherein at least one positioning member of the first or secondpositioning members is operatively connected to the intermediate portionby a living hinge.
 4. The surgical apparatus according to claim 2,wherein a surgical instrument inserted through the first port causes thefirst positioning member to transition from the retracted position tothe deployed position.
 5. The surgical apparatus according to claim 2,wherein the first and second positioning members diametrically opposeeach other.
 6. The surgical apparatus according to claim 2, wherein thefirst and second ports are in registration with the first and secondpositioning members, respectively.
 7. The surgical apparatus accordingto claim 2, wherein the first and second ports are symmetricallyarranged with respect to a central longitudinal axis defined by the sealanchor member.
 8. A surgical apparatus for positioning within a tissuetract accessing an underlying body cavity comprising: a seal anchormember including a leading portion, a trailing portion, and anintermediate portion disposed between the leading and trailing portions,the seal anchor member defining first and second ports extending betweenthe leading and trailing portions, the leading portion including firstand second positioning members transitionable between a retractedposition in which the first and second positioning members areconfigured to obstruct passage of surgical instruments inserted into therespective first and second ports and a deployed position in whichsurgical instruments inserted into the respective first and second portsurge the respective first and second positioning members outward toenable passage of at least a portion of the surgical instruments throughthe seal anchor member, the first and second positioning members biasedtoward the retracted position.
 9. The surgical apparatus according toclaim 8, wherein the first and second positioning members in thedeployed position are configured to secure the seal anchor member withinthe tissue tract.
 10. The surgical apparatus according to claim 8,wherein the first and second ports are symmetrically arranged withrespect to a central longitudinal axis defined by the seal anchormember.
 11. The surgical apparatus according to claim 8, wherein theleading portion defines a first diameter when the first and secondpositioning members are in the retracted position and defines a seconddiameter larger than the first diameter when the first and secondpositioning members are in the deployed position.
 12. The surgicalapparatus according to claim 8, wherein the first and second ports arein registration with the respective first and second positioning memberssuch that insertion of surgical instruments through the respective firstand second ports secures the seal anchor member within the tissue tract.13. The surgical apparatus according to claim 8, wherein the first andsecond ports are configured to receive respective surgical instrumentsin a sealing relation.
 14. The surgical apparatus according to claim 8,wherein the first and second positioning members extend radially inwardin the retracted position.
 15. The surgical apparatus according to claim8, wherein the first and second positioning members extend radiallyoutward in the deployed position to secure the seal anchor member withinthe tissue tract.
 16. The surgical apparatus according to claim 8,wherein at least one positioning member of the first or secondpositioning members is connected to the intermediate portion.
 17. Thesurgical apparatus according to claim 16, wherein the at least onepositioning member of the first or second positioning members isoperatively connected to the intermediate portion by a living hinge.